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The monetary value of a life year: evidence from a qualitative study of treatment costs
Author(s) -
McKie John,
Shrimpton Bradley,
Richardson Jeff,
Hurworth Rosalind
Publication year - 2011
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.1660
Subject(s) - equity (law) , normative , deliberation , context (archaeology) , actuarial science , qualitative research , value (mathematics) , economics , baseline (sea) , health economics , public economics , public health , medicine , nursing , sociology , political science , paleontology , social science , machine learning , politics , computer science , law , biology
A small number of studies have provided suggestive evidence that the general public rejects the idea of giving higher priority to low‐cost patients, in the context of a limited budget, in order to maximise health benefits. The study reported here used semi‐structured group discussions to investigate the normative bases of such views among the Australian public. Discussion groups help participants reflect critically upon their own reasoning processes and go some way towards revealing underlying values rather than unreflective preferences. As a part of the exercise, participants were asked to allocate a hospital budget. After discussion and deliberation only three out of 41 chose to allocate all of the money to the low‐cost patients. Reasons were not based on conceptual confusion or lack of insight into the implications of the different strategies, but rather on views about fairness, including the importance of giving all groups a ‘chance’ of being treated and of not removing ‘hope’ from high‐cost patients. The results suggest that as costs rise people are willing to pay more than the minimum cost of a quality‐adjusted life year for equity reasons, indicating that caution must be exercised in estimating a single monetary value for a QALY. Copyright © 2010 John Wiley & Sons, Ltd.